BACKGROUND:Point resolved spectroscopy (PRESS) or single-voxel spectroscopy (SVS) is always used in the previous researches of magnetic resonance spectroscopy (MRS) and its regions of interest are mainly located in focal zones which can be observed with magnetic resonance imaging (MRI); however, both of them cannot manifest the changes of focal marginal zone. Contrarily, hydrogen magnetic resonance spectroscopy (1H-MRS) can det ect the all regions of brain.OBJECTIVE: To observe the 1H-MRS manifestations of patients with heroin spongiform leucoencephalopathy (HSLE) so as to analyze metabolic regularities of N-acetyl aspartate (NAA), creatine (Cr) and bilineurine (Cho) in brain.DESIGN: Case-contrast observation.SETTING: Department of Neurology, Nanfang Hospital.PARTICIPANTS: Three HSLE patients including 2 males and 1 female who were diagnosed with clinical imaging were selected from the Department of Neurology, Nanfang Hospital from August 2005 to August 2006, and all of them were regarded as the case group. In addition, 10 healthy volunteers were regarded as the control group.METHODS: Siemens Megnetom Vision Plus 1.5T superconductive magnetic resonance (MR) system and standard head coil were used in this study, and then, all subjects were checked with 1H-MRS.MAIN OUTCOME MEASURES: Levels of NAA, Cr and Cho in white matter of frontal, parietal and occipital lobes, metabolic maps of them and ratios of NAA/Cr and Cho/Cr.RESULTS: All 13 subjects were involved in the final analysis. ① NAA level: The level of NAA in white matter of frontal,parietal and occipital lobes of case 1 was lower than that of the subjects in the control group (79.50±21.65, 96.75±16.14,77.05±22.47; 146.07±15.49, 117.77±14.56, 120.83±16.02; P ＜ 0.05, 0.01); meanwhile, white matter of parietal lobes of case 2 and case 3 was also lower than that of subjects in the control group (87.50±7.89, 80.65±11.73, P ＜ 0.01). ② Cr level: There were no significant differences of the Cr level of all subjects in both case group and control group (P＞ 0.05).③ Cho level: Except white matter of frontal lobes in case 1, the level of Cho was lower in the case group than that in the control group (P ＜ 0.01). ④ Ratio of NAA/Cr was lower in the case group than that in the control group, and the radio of Cho/Cr was decreased remarkably. ⑤ Metabolic maps of NAA and Cr manifested a low signal in focal site. ⑥ Ratio of Cho/Cr was obviously reversed in focal marginal zone, but wave of lactic acid was not observed at the same time.CONCLUSION:The area with abnormal metabolites in HSLE patients showed by 1H-MRS is obviously larger than the visible lesion area showed by MRI.There are abnormal metabolites in the adjacent area of HSLE lesions.

65Y) on maintenance hemodialysis at our hospital from Jan 2005 to Oct 2006 was selected.All subjects were divided into two groups according to serum albumin level:group A(ALB0.05);and mortality was higher in group A than in group B(P

Intracranial branch atheromatous disease (BAD) was proposed by Caplan in 1989.It has been widely studied in Japan in recent years.With the application of high-resolution magnetic resonance,BAD has become a hot topic.This article reviews the concept,etiology,pathology,diagnosis and treatment of BAD as well as its relationship with ischemic stroke.

Objective:To report the diagnosis and surgical treatment of a special type of Maisonneuve injury.Methods:A total of 4 patients were treated at Department of Orthopaedics, Beijing Chao Yang Hospital from January 2015 to July 2019 for Maisonneuve injury. They were 3 males and one female, aged from 34 to 61 years (average, 45.3 years). All injuries were closed, initially manifested as posterior dislocation of the ankle on X-ray films and X-ray and CT re-exams after manual reduction showed fine reduction with no obvious fracture of the ankle joint. Consequently the diagnosis of their Maisonneuve injury was missed in emergency visits, but re-exams in outpatient visits showed separation of distal tibiofibular syndesmosis. All the patients were treated by restoration of the fibular length, fixation of the distal tibiofibular syndesmosis and repair of the triangular ligament. American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score was used to evaluate functional recovery of the ankle joint at 12 months after operation.Results:All the 4 patients were followed up for 12 to 14 months (average, 12.7 months). The fractures united after 110 to 185 days (average, 149.3 days). No post-operative complications like infection, delayed union or nonunion were observed. The AOFAS score at 12 months ranged from 82 to 96 points (average, 90.5 points), giving 3 excellent and one good cases.Conclusions:The Maisonneuve injury which is clinically manifested as posterior dislocation of the ankle with no obvious fracture of the ankle joint is likely to be missed in clinical diagnosis. Therefore, X-ray exam of the full length tibia and fibula should be taken in physical examination after reduction for the patients with simple posterior dislocation of the ankle. Once the special type of Maisonneuve injury is diagnosed, surgical treatment is indicated. Satisfactory treatment efficacy can be achieved by fixation of the distal tibiofibular syndesmosis and repair of the triangular ligament.

Tangcao pill is commonly applied in adjuvant and even alternative therapy for patients with AIDS. However, the herb contains complex ingredients, but with unknown effect against anti-HIV drug and unknown function. Because CYP450 emzyme is the main metabolic enzymes of the drug, it is of important significance to study the regulation of CYP450 enzymes before and after the combined administration of Tangcao pill and EFV. Proteomics, due to its high throughout and high sensitivity, has been widely applied in CYP450 enzyme study. In this paper, liver microsomes were separated through differential centrifugation. Their proteins were separated through SDS-PAGE. The three protein bands that CYP450 enzymes were located were cut and identified by liquid chromatography tandem mass spectrometry. Totally 16 CYP450 isoenzymes were identified. Furthermore, in order to make a quantitative analysis on the effect of tang herb on CYP450 emzyme, the multiple reaction monitoring (MRM) technology based on MS was adopted. The CYP2C11 was selected based on the results of the mass spectrum identification of proteins. The characteristic polypeptides were obtained through searching Expasy blast database. The m/z of the fragment ions was less than 800. In the paper, the m/z of ion pairs of CYP2C11 were 711.5/232.1, 711.5/319.2, 711.5/466.2 and 711.5/595.3, and the m/z of ESAT-6 (internal standard, IS) were 735.5/215.3, 735.5/389.3, 735.5/460.3 and 735.5/524.3. The relative peak (analyte/IS) area was adopted for the relative quantitative analysis. Compared with the EFV single administration group, the EFV and Tangcao pill combined administration group showed a 1.6-fold increase in CYP2C11. The results of the paper indicated that Tangcao pill may affect drug metabolism by regulating metabolic enzymes such as CYP2C11, but the specific mechanism still unknown.
Animals ; Cytochrome P-450 Enzyme System ; chemistry ; genetics ; metabolism ; Drugs, Chinese Herbal ; administration & dosage ; Electrophoresis, Polyacrylamide Gel ; Male ; Microsomes, Liver ; chemistry ; drug effects ; enzymology ; Proteomics ; Rats ; Rats, Sprague-Dawley

Objective To investigate the correlation between plasma homocysteine (Hcy) level and cerebral microbleeds (CMBs) band leukoaraiosis (LA) in patients with acute stroke.Methods The clinical and imaging data of patients with acute stroke were analyzed retrospectively.The numbers of CMBs were counted and the severity of LA was graded according to the results of MRI.Fasting venous samples were obtained and the plasma Hey concentration was measured the next day after admission.Results A total of 139 patients with acute stroke were enrolled,67 of them were females and 72 were males (mean age 70.1 ± 10.2 years); 24 had hemorrhagic stroke and 115 had ischemic stroke.The age (76.23 ± 8.74 years vs.64.58 ± 7.42 years;t =4.621,P =0.012) hypertension ratio (89.13％ vs.67.74％ ;x2 =8.324,P =0.0 370) and plasma Hey level (14.53 ± 4.31 mmol/L vs.11.31 ±3.16 mmol/L;t =6.538,P=0.008| in a severe LA group (n=46) were significantly higher than those in a non-severe LA group (n =93).Spearman correlation analysis showed that there was significant correlation between the plasma Hcy level and the severity of LA (rs =0.365,P =0.002).Multivariate logistic regression analysis showed that the increased Hey level (odds ratio [ OR ],1.366,95％confidence interval [ CI] 1.141 - 1.526; P =0.010) and age (OR 1.093,95％ CI 1.031 - 1.162; P =0.016)were the independent risk factors for severe LA.The age (74.37 ± 6.35 years vs.67.56 ± 8.52 years; t =6.628,P =0.038) and hypertension ratio (94.74％ vs.62.20％;x2 =8.773,P =0.002) in a CBM group were significantly higher than those in a non-CMB group (n =82).Spearman correlation analysis showed that there was no significant correlation between the plasma Hcy level and the numbers of CBMs (rs =0.038,P =0.813).Multivariate logistic regression analysis showed that hypertension was an independent risk factor for CBMs.Conclusions The elevated plasma Hcy level was associated with LA,but it was not associated with CBMs.

Objective To investigate the clinical significance.of thrombocytopenia in systemic lupus erythematosus (SLE).Methods One hundred and two SLE patients with thrombocytopenia who were admitted to Peking University People's Hospital were involved in the study.SLE patients without thrombocytopenia were controls.Clinical and laboratory characteristics were analyzed.T-test and Chi-square test were used for inter-group comparison.Results Patients with thrombocytopenia had more organ damage than those without,although the disease activities (SLEDAI) were not different between these two groups.Bone marrow characteristics were analyzed and 16 patients were amegakaryocytic.However,there were no differences observed between patients with amegakaryocytosis and normal megakaryocytes in organ damage,disease activity and response to therapy.Conclusion Lupus patients with thrombocytopenia usually have more organ damage.About 32％ of those patients are amegakaryocytosis.

OBJECTIVE To enhance the rational usage of antibiotics by comprehensive interventional measures in clinics.METHODS Several interventional measures have been adopted in our hospital since January 2001: to(establish) expert team on antibiotics usage and administration consultation;constitute antibiotics use criteria(suitable) for each clinical specialty;train and examine the usage of antibiotics;censor the distribution of pathogen and drug-resistance variance.Then 10% of the discharged medical records in 2000,2002 and 2004 were drawn out respectively to analyze the usage of antibiotics and the isolation of pathogen from nosocomial infection cases.(RESULTS) The proportion of the patients with prophylactic and remedial indications was increased remarkably((P

This article introduced the experience of Professor YU Yun in treating the primary carcinoma of liver by using acupuncture after pulse diagnosis. Professor YU thinks that the overall pathogenesis of liver cancer is deficiency of zang-fu organs, so the cancer cells can invade and occupy in the liver. Therefore, Professor YU uses the way of supporting the healthy qi and driving out the cancer as the treatment principle from multiple organs and meridians. On the basis of the theories of Nei Jing, Professor YU creates the acupuncture after pulse diagnosis. He feels the pulse on the basis of four pulses: Cunkou, Renying, Chongyang, and Taixi. According to the feelings of the pulses, he compares the size and speed, strong or weak, smooth or nonfluency of the four pulses. In treatment, he uses reducing method when the pulse is strong and fast, and tonic method when the pulse is weak and slow. He chooses the main acupuncture points on head, face, belly, flank and lower limbs. According to the experience, Professor YU uses gold needle in tonic method and uses silver needle in reducing method. In this way, the acupuncture after pulse diagnosis can regulate zang-fu organs and meridians, yin and yang, qi and blood, and promote blood circulation for removing blood stasis and resolving dampness, and attack the retained fluid and tumour in the liver, and combined with adjunct points to treat cancer.

Objective To investigate the relationship between CRP, plasminogen activator inhibitor type 1 (PAI-1) levels, PAI-1 gene promoter 4G/5G polymorphism and the type of acute myocardial infarction (ST elevation myocardial infarction, STEMI vs the non-ST elevation Myocardial infarction, NSTEMI). Methods One hundred seventy-six consecutive patients with AMI were included for the study, of whom 60 had STEMI and 56 had NSTEMI, and 60 adults without cardiovascular and cerebrovascular disease were selected as controls. Blood samples were obtained from patients within 6 h of AMI and the plasma PAI-1, CRP, and the gene polymorphism were measured. Results Plasma levels of PAI-1 and CRP were higher in AMI groups, compared those in the control group, and plasma levels of PAI-1 were significantly higher in patients with STEMI compared to those with NSTEMI (80.12ng/ml VS.73.01ng/ml, P <0.01), while CRP levels were not significantly different between patient with STEMI and NSTEMI (3.87±0.79 mg/ml VS.4.01±0.69mg/ml, P>0.05). PAI-1 levels presented a significant correlation with CRP levels in the NSTEMI subjects. However, PAI-1 and CRP levels could explain the lack of a significant relationship between them in control and STEMI subjects.The frequencies of 4G/4G genotype in the AMI group were higher than those in the control group and higher in patient with STEMI than in patient with NSTEMI. Plasma levels of PAI-1 in subjects with 4G/4G genotype were significantly increased as compared to those in subjects with 4G/5G and 5G/5G genotype. Conclusions Plasma PAI-1 levels were associated with different myocardial infarction type, and PAI-1 promoter 4G/5G polymorphisms and CRP may be related to plasma PAI-1 levels.